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Contents Preface Acknowledgements 1 The threat to the body: the role and requirements of the immune system 1.1 The role and complexity of the immune system 1.2 Pathogens differ in size, lifestyle and how they cause disease 1.3 How do pathogens cause disease and what protection is there? 1.4 Conclusion 1.5 Summary 1.6 Questions and answers 1.7 Further reading 2 The immediate response to infection: innate immunity and the inflammatory response 2.1 The response to infection 2.2 The immediate response to infection - the innate immune system 2.3 Cytokines - hormones of the immune system 2.4 The inflammatory response and cell migration 2.5 Cell migration - through blood and into tissue 2.6 The inflammatory response 2.7 Systematic inflammation - involvement of the brain and liver 2.8 Opsonins cans 2.9 Interferons and natural killer cells 2.10 The innate immune response limits the early replication of pathogens 2.11 Summary 2.12 Questions and answers 2.13 Further reading 3 Specific immune recognition: B lymphocytes and the antibody molecule 3.1 Introduction to the specific immune system 3.2 Antibody structure 3.3 Recognition by antibody - antigens and epitopes 3.4 There are different antibody classes with different biological functions 3.5 Antibody can be secreted or expressed on the cell surface of B lymphocytes 3.6 Summary 3.7 Questions and answers 3.8 Further reading 4 T lymphocytes and MHC-associated recognition of antigen 4.1 There are different types of T lymphocytes 4.2 T cells recognise antigen through their T cell receptor (TCR) 4.3 The major histocompatibility complex 4.4 Recognition of antigen by T cells 4.5 Antigens must be processed before they can be presented by MHC molecules 4.6 Summary ; 4.7 Questions and answers 4.8 Further reading 5 Lymphocyte development and the generation of antigen receptors 5.1 The production of lymphocytes: lymphopoiesis 5.2 B lymphocytes are produced in the bone marrow 5.3 T lymphocytes finish their production in the thymus 5.4 During their development lymphocytes must generate huge numbers of Ig and TCR receptors with different antigen specificities 5.5 Developing lymphocytes rearrange their lg or TCR genes in a carefully controlled order 5.6 Why is there continuous production of lymphocytes, most of which die? 5.7 Summary 5.8 Questions and answers 5.9 Further reading 6 Anatomy of the immune system 6.1 Requirements of the immune system in vivo 6.2 Different pathogens require different types of immune responses 6.3 The anatomy of the lymphoid system promotes the interaction of cells and antigen 6.4 Lymphocytes continually recirculate through blood, tissues and lymphatic vessels 6.5 Summary 6.6 Questions and answers 6.7 Further reading 7 Anatomical and cellular aspects of antibody production 7.1 Overview of antibody production 7.2 Activation of CD4 T cells (0-5 days) & 7.3 Stimulation of B cells by antigen and their interaction with Th (0-5 days after antigen) 7.4 Formation of germinal centres (4-14 days after antigen) 7.5 MALT and the production of IgA 7.6 Summary 7.7 Questions and answers 7.8 Further reading 8 Effector mechanisms: dealing with pathogens in vivo (1) Antibody-mediated responses 8.1 Humoral and cell-mediated immunity 8.2 Antibodies provide protection in many different ways 8.3 Neutralisation by antibody 8.4 Antibodies can cause agglutination of microbes 8.5 Antibodies can act as opsonins and promote phagocytosis 8.6 Complement is a protein cascade with antimicrobial functions 8.7 Antibody and complement synergise to promote the opsonisation of microbes 8.8 Antibody-dependent cell-mediated cytoxicity (ADCC) 8.9 Summary 8.10 Questions and answers 8.11 Further reading 9 Effector mechanisms: dealing with pathogens in vivo (2) Cell-mediated immunity 9.1 Introduction 9.2 CD4 T cells develop into different types of helper T cells 9.3 CD8 cytotoxic T cells are important in intracellular infections 9.4 Delayed-type hypersensitivity and the activation of macrophages 9.5 Th2 responses are important against worms p; 9.6 Th17 responses involve high levels of inflammation 9.7 Different effector responses have different costs to the host 9.8 Summary 9.9 Questions and answers 9.10 Further reading 10 Immunological memory and vaccination, the production and use of antibodies 10.1 Immunological memory - the basis of immaturity 10.2 Vaccines induce immunity without causing disease 10.3 Antibodies can be produced and used in many ways in treatments and in tests 10.4 Summary 10.5 Questions and answers 10.6 Further reading 11 Immunological tolerance and regulation - why doesn't the immune system attack ourselves? 11.1 Immunological tolerance - what is it and why do we need it? 11.2 Self-tolerance in B cells 11.3 Self-tolerance in T lymphocytes - selecting for recognition of self-MHC but not self-antigen 11.4 How do we maintain tolerance to self-antigens not expreseed in the thymus? 11.5 Summary 11.6 Questions and answers 11.7 Further reading &nbp; 12 Autoimmune diseases 12.1 Autoimmune diseases occur when our immune systems attack our own bodies 12.2 There are many different autoimmune diseases 12.3 Immunological features of autoimmune diseases 12.4 Both genetic and environmental factors contribute to the development of autoimmune disease 12.5 How is immunological tolerance lost in autoimmune disease? 12.6 Summary 12.7 Questions and answers 12.8 Further reading 13 Allergy and other hypersensitivities 13.1 Introduction 13.2 Type I hypersensitivity and allergy 13.3 Allergies result in a variety of clinical symptoms 13.4 Testing for allergy 13.5 Both genetics and the environment contribute to allergy 13.6 Why have IgE in the first place? 13.7 Treatment of allergy 13.8 Type II hypersensitivity 13.9 Type III hypersensitivity 13.10 Differences between type II and type III hypersensitivity 13.11 Delayed hypersensitivity and contact hypersensitivity 13.12 Summary 13.13 Questions and answers 13.14 Further reading 14 AIDS 14.1 History and incidence of AIDS 14.2 The human immunodeficiency virus 14.3 Clinical course of HIV infection 14.4 Immunological events associated with HIV infection 14.5 Chemotherapy can prolong the life of HIV-infected people 14.6 HIV has proven very difficult for vaccine development 14.7 Summary 14.8 Questions and answers 14.9 Further reading 15 Manipulating the immune system: transplantation and tumours 15.1 Introduction 15.2 Transplantation: from kidneys to faces 15.3 Using the immune system against tumours 15.4 Summary 15.5 Questions and answers 15.6 Further reading Glossary Index

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